Assessment of pulmonary vascular resistance via doppler echocardiography in ischemic heart disease with reduced ejection fraction

Abstract

Objectives: To determine pulmonary vascular resistance (PVR) by echocardiography - Doppler; and evaluate the correlation between pulmonary vascular resistance and some variables such as left ventricular EF, PASP, TAPSE, and tissue S-wave of the tricuspid valve in patients with ischemic heart disease. Method: Observational study on 82 heart failure patients with reduce ejection fraction brought upon by ischemic heart disease, at the Cardiology Department of the University of Medicine and Pharmacy from 04/2016 - 05/2017. Results: The average PVR is 3.91 ± 1.85 WU. There was not significant difference between age and gender groups (p > 0.05), but there was a statistically significant difference of PVR in patients with NYHA III and IV compared to NYHA I, II (p < 0.05). When EF < 30%, the rate of increased PVR is higher than the normal value (35.4 % vs 4.9%). There is a strong correlation between LVEF and PVR (r = - 0.545, p < 0.001), especially when PVR < 8 WU (r = - 0.618, p < 0.001). When the PASP increases, the rate of increased PVR is higher than normal value (54.9% vs. 9.8%, p < 0.001), with an enough correlation coefficient (r = 0.361, p < 0.001). In patients with RV systolic dysfunction evaluated by TAPSE and S’ wave, there was a significant difference in the rate of increased PVR from the normal value (41.5% vs 1.2%; 34.1 vs 8.5%, p 0.001). PVR is closely correlated with TAPSE (r = -0.590; p < 0.001) and is inversely correlated with S’ wave (r = -0.590; p < 0.001). Conclusions: Increased PVR is the primary mechanism for pulmonary hypertension and right ventricular dysfunction in patients with HFrEF brought upon by IHD. The evaluation of PVR in patients with left ventricular dysfunction by echocardiography is important in clinical practice